31 | Brain Fog, Hot Flushes & To-Do Lists: Productivity in Perimenopause

Is it brain fog… or just your to-do list playing tricks on you?

In this powerful and practical episode, I am joined by Vikki Ellison, Advanced Menopause Specialist Nurse Practitioner and founder of the Calm Menopause & Wellbeing Clinic, to explore the real impact of perimenopause and menopause on how we work, think, and feel.

Whether you're running a business, leading a team, juggling kids, or simply trying to remember what day it is... this one’s for you.

Together, we dig into:

• What perimenopause and menopause actually are (and why symptoms like anxiety, forgetfulness, and fatigue can sneak up on you)
• Why productivity can feel impossible during this season, and what to do about it
• How to advocate for yourself at work (yes, including meetings with HR!)
• Simple tweaks to your routine that can ease symptoms and boost focus
• When to consider HRT, what the options are, and what to know about supplements like magnesium and ashwagandha.

You’ll also hear Vikki’s take on how to build a menopause-friendly workplace culture, and my personal reflections on why it’s time to stop blaming ourselves for “not being productive enough.”

You are not broken. Your to-do list just needs a little compassion (and maybe a fan).

🎧 Links & Resources:

• Visit Vikki’s website and take the Greene Climacteric Scale
• Follow Vikki on Instagram and Facebook @CalmMenopause
• Read the Blog

💌 Loved this episode? Share it with a friend, tag me @jasmineclarkecoach, and leave a review wherever you listen!

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Transcript

Vikki Ann Ellison: Podcast Guest

[00:00:00] 

 Hello everyone, and welcome to two days episode of Productivity with Zest. I am thrilled to introduce our guest today and that is Vicky Ellison, who is an advanced menopause specialist nurse practitioner, and she has over 33 years experience in the NHS.

[00:01:00] She's the founder of the Calm Menopause and Wellbeing Clinic in Aly Bridge in West Yorkshire, where she spots women through perimenopause and menopause with evidence-based advice and everything else that's involved in that. I met Vicky at a networking event a few weeks ago, and she's another one of those people that I just clicked with, and I think she's really great.

And I was really interested in hearing how the perimenopause and menopause can have an impact on the way we work and our productivity. So Vicki, welcome. Why don't you start off by telling us a bit about yourself and your work? 

Okay, so thank you for inviting me, Jasmine. I've been a nurse, for 33 years for, so the first 10 years I worked in intensive care in St.

James' in Leeds and the LGI in Leeds. And then when it came to wanting to, get married and start a family, the work life balance just wasn't going to work and shift where wasn't for me. So I moved into general practice and became a [00:02:00] practice nurse. So that then started as an asthma nurse and a heart failure nurse and many other roles.

And then I became a female health nurse. And in that time I did contraception, smears, and then slowly evolved into, menopause. And I've been studying menopause now for the past. Six or seven years and feel really proud that I've managed to become an advanced menopause specialist, nurse practitioner

amazing. That sounds like you know your stuff and it's such a hot topic at the moment, isn't it? Menopause and perimenopause. So you recently launched Calm, menopause and Wellbeing. What inspired you to focus specifically on this? 

So I think the reason I felt I wanted to do this was because I have all this experience and knowledge and it, it does appear to be a postcode lottery for people to get the correct [00:03:00] advice and treatment when it comes to perimenopause and menopause.

So I decided to set up Calm Menopause and Wellbeing Clinic. I chose ALA Bridge because it's a good area to be. It's accessible for lots of people and I just want to be able to. Be a bit like the in-between person if somebody's struggling to get in with the GP or if gps aren't listening, or just refuse HRT if that's what's needed.

I want to be that person that can be like the middleman and help people with the menopause and set them up on their journey really. 

So you operate out of Apley Bridge and you do online as well, don't you? I, on your website. 

Yeah, so currently because I'm still working for the NHSI work three days a week in general practice, and I'm doing Fridays at Apple Bridge face-to-face or online. I'm doing every second Saturday of the month, and I [00:04:00] do offer to online appointments on a Wednesday evening.

Amazing. Wow. That 

sounds like you're juggling quite a lot. Well, I am because this is my retirement plan in the next couple of years, so I need to build it up and then hopefully I'll still work for the NHS, but not as much because this is the way I want to, spend the next 10, 15 years in sort of my semi-retirement date, should I say.

I'm sure lots of my listeners will resonate with that. Lots of people start these side hustles that then become their retirement plans, their businesses.

So your role, as they said, advanced menopause specialist nurse. What kind of support does your clinic offer to people? 

I think the main thing is that when you, in the NHS, you get between 10 and 15 minutes to discuss your problems. So that's the first thing. My clinic allows an hour so the whole of the menopause journey can be [00:05:00] discussed and looked at what, options there are.

It may be that not everybody wants hormone replacement therapy. It may be that they want alternative therapies, so we have that time to discuss. What treatment is best for that person. And then if hormone replacement therapy is what's required, I then can do a prescription, through a chemist that will deliver that prescription.

And then my hope is that the GPS will take over the care of the patient because in theory, it should be available on the NHS. , But if they won't, I will happily see them every three months until this, um, settled on the treatment and then I'll, see them on a yearly basis. So, like I say, I said at the beginning, I'm like the middle person.

I want to get people on the right treatment and then refer them back to the GP surgery. 

So [00:06:00] perimenopause and menopause are words that are, they're really kind of battered around at the moment. They're becoming more words that people are talking about, and I'm not sure if it's because I am reaching the age where lots of my friends are starting to experience symptoms.

But for listeners who may not be familiar, how do you define menopause perimenopause? What are their symptoms? Typical timelines? Just give us some of the inside info, please. 

So the symptoms for perimenopause and menopause are pretty similar. The difference being is the perimenopause is when you probably still having periods.

Now they may be very normal and regular for you, but they may be shorter, longer, heavier, lighter. So that's tends to be the perimenopause, whereas the menopause is actually diagnosed in retrospect because you need to have been 12 months. Without a period for, that diagnosis to be made. But then the symptoms are [00:07:00] pretty similar for both.

You may find it's hot flushes and night sweats, but that's not necessarily for everybody. They seem to be the ones that everybody thinks are the main symptoms, but quite often it can be more low mood, mood swings, that feeling of rage, anxiety. Then the aching joints. And bones, brain fog, poor concentration, palpitations, some people feel socially withdrawn.

And then one of the other big issues can be that libido can, drastically reduce when there's been no change in, lifestyle or anything, or relationships. That's only. Scratching the surface of symptoms. There's up to at least 45 50, but they seem to be the main ones. 

Gosh, 45, 50 symptoms.

Yeah. And some of them are quite bizarre . Difficulty driving women suddenly can't go on motorways feeling [00:08:00] quite anxious. Some of the unusual ones tend to be, like there's the itchy skin and did I say itchy ears?

Wow. Itchy ears. So, right. I'm gonna be watching out. My ears are ITing now, actually. Just thinking about it. And what are the kind of typical timelines, when do people start to get these symptoms? 

So perimenopause can start. At any age. Generally it's mid forties, but it can be as young as, mid thirties and can go on for two to 10 years.

Menopause is generally the average age of menopause is 51 in the uk. But again, that can be sooner. And I think the thing to remember is that for women who stop the periods. At a young age, sort of 45 and below, unless they're on contraception.

It's not good for our long-term health not to have the estrogen and the progesterone of the, [00:09:00] hormones that we need to protect our heart from heart disease and our bones from bone disease. So as much as yes, it will be nice not to have periods, quite often a conversation should be had as to whether you should be actually going onto HRT for that protection of hearts and bones.

And that sort of leads onto what the perimenopause and menopause is. Your hormones are fluctuating, so they're up, down, up, down. And that's why we tend not to do blood tests to see if you are perimenopausal, because they're just not, accurate. So we tend not to go with blood test results.

We tend to go more with symptoms, whereas menopause, they're not just as up and down, aren't the hormones. They slowly, slowly declining till they at quite a flat level. 

Wow. One thing really struck me there, where you said that perimenopause could be, you know, mid forties, even [00:10:00] thirties, mid late thirties.

And what struck me was for a lot of women, this is almost their prime work time. Mm-hmm. So for me, I had my children at 27 and 30, and then by the time I was 35 and my son went to school. That's when I was like, right now this is my time to work. And then if you start getting hit with these symptoms of the brain fog, itchy ears, which I'm definitely, that is a first for me.

But when you start getting hit with these symptoms, when you are in your, this is my time to work, that must feel so frustrating for people. 

It is frustrating. It can make it very difficult. And also there's quite often the additional, issue of if you've had your children later and so you've then got teenagers around the time that your perimenopausal menopausal.

But then some people also have elderly parents, so they call it the sandwich generation and you're [00:11:00] trying to juggle. Looking after elderly parents, teenage children, and keeping this career going that you've worked so hard to get. So it can be really difficult people do leave their jobs because of symptoms of the menopause, and it doesn't need to be that way at all,

people need the time to talk about all their symptoms, which a lot maybe don't even realize they've got until you speak to a specialist 

man, just thinking about the impact of all those things on the women for their children, you know, might have teenagers.

They might have, like you said, the elderly parents and they're in their prime of their career, and then suddenly they're hit with this anxiety they've never had before. They're not sleeping like they were before. They're having hot flushes in meetings when they should be in control and showing like they've got everything together.

But if they're not thinking that they're part of the menopause, that must [00:12:00] really affect their mental health. Oh, 

absolutely. Yeah. And I mean, mental health is a big thing. Um, part of menopause anyway, because you can be. In a state of rage, and then within minutes you can be so emotional and it's difficult for you to accept and to understand, but it's even harder for your colleagues or your family at home to accept and there is a change in how you are.

And that can be very difficult for people to actually accept. And deal with, but it doesn't have to be that way that you don't have to go onto HRT, which is hormone replacement therapy, but if you choose to go onto it, it can transform people's lives within weeks. 

We'll get onto the strategies definitely. And how my lovely listeners who are maybe thinking, Ooh, this might be me and I need some help. The kind of questions they can ask of their health practitioners and people they [00:13:00] seek support from. But what do you think are the most common productivity challenges that you see in your clients when they're navigating perimenopause, menopause?

I think probably the first thing would be identifying what symptoms you've got and what changes. It's also being able to have that open relationship or open discussion with your line manager, your work colleagues. And it's not so that everybody knows what's going on, but it's so that people, maybe judging you or treating you differently and trying to work out what's best to help you get through and manage how you feel.

There's no point just somebody saying they've got a menopause policy and sticking a fan on your desk. If actually hot flushes aren't your thing, it may be that you need to. Postle is a big issue with, menopause and perimenopause, so [00:14:00] it may be that you need to change your hours. So that you, if you're not sleeping, you can sleep in a bit longer in the morning, but do your work later in the day.

So it's moving things around to suit you. Now not everyone will be able to change hours. Not everyone will be able to drop hours and they shouldn't, but there should be that ability to look at what's there and available within the workplace, to try and help women. 

And if people are running their own business, then this.

It's a bit of an, uh, alarm bell for them to adjust their own work potentially. So if you are running your own business and you're feeling like my sleep is really struggling, then not pushing yourself to do that productivity thing that people push of Get up at 5:00 AM and do it all, do do, do and then keep going.

And then do three days worth of working 24 hours and. My regular listeners know that I do not subscribe to that hustle culture and that version of [00:15:00] productivity. And potentially when you have these things like brain fog, which maybe really affect your focus and the amount of stuff that you can get done, which may be very frustrating if you're used to being able to be on it and focused.

Actually going back to what are your main goals? What do you wanna get out of your business? What are the key important tasks and focusing on them with the headspace and the mental clarity that you have? Dunno if you've got anything else to add to that. Vicki? Any advice for that? , I 

think it is looking at or listening to your body.

And also, making sure you're eating well. So one of the things that can really aggravate, perimenopausal menopause symptoms is having an unhealthy diet. However, one of the other things we didn't mention in symptoms is weight gain, particularly around the middle, the. Belly fat or rubber ring like some people will say.

And that's because of the way we're feeling, we start to eat more unhealthily. So [00:16:00] we crave more sugars, we crave more carbohydrates. We then sometimes can't be bothered, so we end up eating ultra processed foods. So it's making sure you look at what you're eating to fuel your body. That hopefully will help with some of the symptoms.

Um, and also exercise. It's taking regular exercise to hopefully try and make yourself feel better. Now, some women feel so bad with the symptoms of menopause and perimenopause, that eating healthy and exercising is the last thing on their mind. And it may be that that's when they need to then start on HRT to

deal with, or treat the problems, then they can start looking at a healthier diet, taking more regular exercise. And then another thing, when I said there were 45, one of them is, vaginal dryness and discomfort and needing to go to the toilet more. [00:17:00] So again, it's having that in the workplace knowing that you are not gonna be in a three hour meeting if you need to go to the toilet, and just maybe planning slightly ahead what your symptoms are and how you can deal with them.

There's lots of strategies there, and what I'm hearing is, uh. What are your specific symptoms that you are feeling? How is that affecting you? And how can you put things in place, whether that's speaking to work about what they can put in place to support you because they want to get the best out of you.

Your work want to get the best out of you. They want you to be the most productive you can be. And if you can make some changes, like not having a three hour meeting, something so simple, I wouldn't have even thought of that. But if you do feel like you need to go to the toilet more often, and it is a long meeting, scheduling in breaks so that everybody can go and have a five minute rest.

They can go to the toilet, they can make a cup of tea. That is beneficial for productivity across the board, [00:18:00] whether you're holding in away and fully, fully desperate or not. So that's a really good tip. Have you got any other strategies, either medical or lifestyle things that you could recommend to people to support productivity during menopause?

So the, if you don't want to go on hormone replacement therapy, then there are, um, supplements that you can take. Magnesium is a really good supplement you can take, which is really good for helping with sleep, but it can also help with mood and, migraines and sometimes, with brain fog as well. And then another supplement, which is really good is Ash.

Which is also good for sleep. It calms stresses and it supports the immune system. And it sometimes can be, that it reduces night sweats and hot flushes. The evidence is pretty low, but it's there. And if for somebody who doesn't want to take, hormone replacement therapy, it's an option. Another option is [00:19:00] cognitive behavioral therapy that can help manage mood and anxiety.

And then hormone replacement therapy, is you taking estrogen and progesterone, which can relieve, many or a lot of the menopausal symptoms. However, some women just don't want to take it. Some women can't take it if they've had a breast cancer. But not all people who have had breast cancer will be refused it.

So it, that's again, needs to be spoken to with your healthcare provider. But also it can, not only will it help with the symptoms, but like I said previously, because you are lacking in estrogen and progesterone. It can, help. Boost that and protect you from cardiovascular disease and bone disease moving forward.

And if you think hundreds of years ago, women never got to menopause because they died in childbirth, then they started to get to the age of 45 and [00:20:00] died. So they'd never, got the menopause. And then only at the turn of the, 20th century did women die at 60, but now we live till we're 85, 90, sometimes a hundred, and that's becoming over a third of our lives without hormones, which is quite scary.

So hormones are not a bad thing. They've got great benefit. Particularly if you've got a family history of osteoporosis, dementia, we think it reduces the risk of dementia. So, not only will it make you feel better, but it also helps, with, long-term health, longevity.

Wow. So why do some people choose not to have HIT? 

I think many people are misinformed, so I hear a lot. I can't have HRT because, my mom's had a stroke. But a lot of the hrts we give now are body [00:21:00] identical, so that means that they're matching the hormones that our body naturally produces, and because we give them through the skin, so they call that transdermal, and we give it in either a patch, a gel, or a spray, then the risk of blood clots and strokes is removed.

So, yes. They wouldn't be able to have an oral estrogen tablet, but they can have a, transdermal HRT with no increased risk at all. Some will still know, or their moms will have said, oh, we all got taken off. HRT 20, 30 years ago when there was a big study came out saying it gave you breast cancer and cardiovascular disease.

Such a flawed, piece of research, partly because of the age of the women in the research. They were all in the sixties. And also that it used very strong oral [00:22:00] estrogen, which we really don't use at all very much now. So I think there's a lot of, misinformation out there and people, are told by other people, the negatives, and it's not often you hear positives, but it can have a really positive effect on people's life.

Yeah. I'm thinking about one of my friends who, she's young and she's gone on HIT and she feels amazing because of it. She says like it's completely changed her life. Being on it. And it's amazing to hear that. And if we've got access to that and we should have access to that and it will help us, then that's really great that , we can access it and it can change our lives and we shouldn't let past stigma maybe of how it used to be.

Hold us back. So back onto [00:23:00] workplace. So somebody has realized, right? Yes. I'm definitely in perimenopause. I am struggling in these different ways. I need some adjustments at work in order to do my best. What advice would you give people when they're speaking to line managers or hr? How do they best ask for these changes that they need?

I think it needs to be an open conversation. It will be interesting to see if you have a menopause policy and if you do what's in that policy because, lots of places have a menopause policy, but it's just a Word document and possibly not being looked at to use it in a realistic way. So I think it's worth having, a conversation with your line manager and thinking what you feel will help you. They, it will be very difficult for them to understand what you are going [00:24:00] through. So if you have an idea how you feel things could be changed at work, that should empower you then.

Hopefully they will listen to you and they will change what's necessary. But, I think you need to go in with the specifics. There's no point going in saying a menopausal things have got to change because I. In what way? There's lots of different ways. Like you say, it could be changing the meetings, it could be scheduling things differently.

It may be that all you need is a fan on your desk just to keep you cool. So there's all sorts of things like that that I would suggest. It needs to be what's your symptoms, what's causing you issues with work, and then having that open, conversation with your line manager. 

Great advice. And for those of us that work for ourselves, I think you need to have that conversation with yourself.

I agree. It's, and [00:25:00] looking at how you can factor in the extra exercise, the better food, um. Taking time for yourself, not pushing yourself. Sometimes we just need to take a step back, don't we? And we don't always, realize just how much pressure we're putting on ourselves, but it is, very manageable.

Like I said, there's supplements that people can try, but if they're not working and you're still struggling, then HRT is a really positive, treatment. 

So if you've got people listening who are team leaders or work in hr, what would you say to them to encourage them to create a menopause friendly workspace somewhere that supports people's productivity when they're going through these different things that maybe creates an open culture for them.

I think it's important because they will lose staff and they'll lose valuable staff that they don't need to lose. And [00:26:00] that's not good for the business and it's not good for the person who's leaving. So I think it's important that it's taken very seriously.

Whatever the women are asking for, obviously it's got to fit in with work as well. They can't say, I need to reduce my hours, but want to be paid the same. It just needs to have a conversation of how it will work for both people and people shouldn't be judged by it. And also, like we've said, if you go onto RT.

Or even the supplements and they start to work and you feel better, then productivity will improve. And that's what you're looking for at the end of the day. 

Yeah. So let's create that open culture where people can bring their individual needs, that you listen to them, that there's no stigma and it will benefit the workplace overall.

And keep them in, keep them wanting to stay. 'cause like you said at the [00:27:00] beginning, when people are having these symptoms, they end up leaving work because. They feel like they can't do it anymore, and that doesn't need to be the case. 

And I don't think people realize, a lot of the time people feel it's just stress of the job.

Stress of the job. I'll leave. And that's why sometimes just speaking to a professional who knows about the menopause might say, but have you got hot flushes? Are you joints really aching? You feeling tired all the time? Have you suddenly changed that you don't wanna go out with your friends anymore, or that driving's really difficult

it's things like that that people don't know can all be linked. And so if you put everything together, then it may not be that you have to leave what you're doing. It might just be you need to just take a step back, sort your health out, and then you'll got many, many years ahead of you to work.

So for those listening who are like, yeah, this is me. I'm feeling these [00:28:00] things, what first steps would you encourage them to take? 

So I would first, fill out a, it's called a green Clima Teric Scale. And you can either get that on my website, which I'll say at the end of the, podcast,

and it asks 21 questions about, symptoms and then you can score yourself. And anything over a score of 12 generally, suggests. That you're perimenopausal, menopausal, depending where you are in your cycle. So that's the first step for you to diagnose or tell yourself, I'm perimenopausal or menopausal.

Then it's. Whether you want to go down the route of hormone replacement therapy or whether you want to go down the route of supplements. Supplements you just buy, from any, boots or Holland and Barrett. And there's loads on the internet, but it definitely just makes sure that you're getting a good quality supplement.

And then if that's not working or [00:29:00] you decide, actually no, I want hormone replacement therapy. And again, remembering that if you are younger, your benefits of going on hormone replacement therapy is going to drastically improve your long-term health. Then you need to, try and see your GP or a healthcare professional at your GP that can, treat menopause.

Or if you can't get in with your GP or they won't listen to you, which is quite often a case, then that's where I fit in and hopefully I can help people. 

Yeah. So if people are like, my gps not listening, how can they learn more from you? How can they find you so you can help them? 

So the first thing I would suggest is go to my website, which is www.calmmenopause.co.uk and that's calm menopause, all one word.

And on there is information about my clinic. There's also on there this, scale that you [00:30:00] can print off and work out what your scar is. If you want to book an appointment, you book an appointment on there or you can just send me a message and I can answer any questions. I had a message last week from a lady who is on HRT high doses and her main problem is no libido.

So she is really struggling and testosterone is another hormone that can be given for no libido, but it needs to be given by a specialist. Now, not every GP surgery will have a specialist who will start that, so I've advised her to get some blood tests and I've told her how to do that. And then to book in with me and, if the blood tests show her testosterone's low, we probably will start it.

But she may have to continue on a private, journey with that because her GP probably won't take it on. But again, if it can help her, she's at desperation [00:31:00] with it. If I can help her, then it's a good thing. 

Amazing. So I'm sure lots of people will want to find you, get in touch with you, send out the white flag.

I need you, so I'll put the links in the show notes as well so that people can easily find you or just head straight to Vicki's website now. So anything else? Any other top tips, Vicki, before we wrap up? 

Well, I'm also on Facebook and Instagram, and so that's another way you can find things.

And I tend to put some blogs on, definitely on my website, but link them to Facebook and Instagram, just about different symptoms and what people can expect. So I hope that helps people, realize that they're not going mad, they're not going crazy, they're not losing their mind, that they can still have.

A good job, a happy relationship and manage elderly parents, teenage [00:32:00] children, or even little children. We should be able to, manage that. So I want to be there to help people and I'm aware that a lot of people struggle, to get into the gp. So that's where I hope my clinic is like that. Stop gap.

Thank you so much for being here, Vicki, you have taught me loads, given me lots of food for thought, and hopefully if there's someone listening out there who thinks I'm no longer cut out for this job, or I'm no longer cut out for this business because of the symptoms of menopause perimenopause, hopefully you are inspired.

I'm speaking to you, my lovely listener. You are inspired that actually you can make some changes. To mean that you can still work well in your current job. You've still got a lot of life left. There's a lot that you've got in your head that you can offer, and there's a lot of great stuff that you can do.

So get in touch with Vicki and see if she can help you balance everything out. [00:33:00] Thank you so much, Vicki. 

No, thank you for having 

me.